A Case of Acute Fatty Liver of Pregnancy with Renal Subcapsular Hemorrhage

Korean Journal of Nephrology 2010;29(6):807-812.

Chi Yong Ahn, M.D., Bong Kwan Ryu, M.D., Jong Hoon Chung, M.D. and Hyun Lee Kim, M.D.

Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea

증례 : 신 피막하 출혈을 동반한 임신성 급성 지방간 1예

안치용, 류봉관, 정종훈, 김현리

조선대학교 의과대학 내과학교실

Abstract

Wünderlich syndrome is a spontaneous rupture of the kidney. It is a rare but potentially life-threatening event. The causes are tumor, vascular disease, infection and preeclampsia. Subcapsular hepatic and renal hematoma are rare complications of pregnancy associated with preeclampsia or HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Acute fatty liver of pregnancy (AFLP) is rare, but is a fatal complication of the third trimester of pregnancy. The clinical picture consists of liver failure with coagulopathy, encephalopathy and hypoglycemia. Early recognization of the disorder, rapid termination of pregnancy, and intensive supportive care have improved the prognosis. AFLP should be distinguished from HELLP syndrome. AFLP is usually not associated with renal subcapusular hemorrhage. In this report, we describe a 36-year-old nullipara with twin male fetus at 35 weeks of gestation who had developed renal subcapsular hemorrhage in AFLP.

Key Words: Fatty liver, Acute, Pregnancy, Hemorrhage, Kidney